The onset of addiction symptoms – impulsive and erratic behavior, moody one day and pleasant the next, irregular sleep patterns, loss of appetite, and isolation – typically begin at 15 to 16 years old. But the average start of treatment is at 35 years old, according to a study done by the Treatment Research Institute, or TRI, in Philadelphia.

“Addiction or alcoholism is neurochemical brain based disease. It’s recognized by the American Medical Association; it’s recognized by the American General of Psychiatry,” said Michael Blanche, an addictions specialist counselor with an outpatient private practice in West Chester. “There’s a genetic predisposition to addiction or alcoholism; it’s also environmental.”

But at 15 to 16 years-old kids are in early high school and are likely to get exposed to and experiment with drugs and alcohol.

“I’m only speaking for Rustin, but they do acknowledge that it exists,” said Andrea Kuesel, intervention specialist at Bayard Rustin High School. “It would be incredibly naïve for us to think that there aren’t any kids who are high at any given point in the day.”

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In the West Chester Area School District, if a student is found to be under the influence or admits to it while at school, he or she becomes a drug and alcohol policy violator. He or she is initially suspended for three days and then has a hearing.

“They are required to have a drug and alcohol assessment with a licensed provider,” said Kuesel.

West Chester School district contracts with Rehab After School – an organization that provides outpatient and intensive outpatient programs for addicts – and the district pays for the student to see a specialist at a Rehab After School location. The licensed provider will make a recommendation for the student to do some level of education, treatment or rehab.

“That person is required to follow the recommendations or else they could be up for expulsion,” said Kuesel. “It’s meant to be helpful, it’s not meant to be punitive.”

Adolescents who experiment with drugs and alcohol may never become addicts. After getting exposed to it and trying it, they may not think about it again. But addiction is a disease of thinking, or mental preoccupation with the substance.

“It’s not a question of frequency if it’s an addiction,” Blanche said. “They could be using once every now and then but still have an addiction because, when they use, they can’t stop or it’s out of control or they are always thinking about the next opportunity that they can get high.”

Sixty percent of adults with addiction also have a mental health issue, according to both the National Institute on Drug abuse and the National Alliance on Mental Illness. And for adolescents, 86 percent with an addiction also have a mental health issue, according to another TRI study. So Blanche said he is as comprehensive as possible in his evaluations of patients.

“A lot of times we look at their coping mechanisms, how they manage their mental health issues or their self-esteem issues by using a substance,” said Blanche. “That’s were counseling and therapy can come into play.”

At the middle and high school level, any public school in Pennsylvania is required to have a Student Assistance Program in place. SAP is a program that educates employees on barriers to a student’s education, which includes drug and alcohol addictions, but also other mental health issues such as depression, eating disorders and grief.

“I think sometimes the public has the image of the guidance counselor sitting behind their desk and just writing college applications, and it is so much more than that,” said Kuesel. “If you were here on any given day, there’s crisis stuff that happens; there’s all kinds of stuff that’s happening.”

Kuesel said she has had interventions with students, and she will call parents if teachers or faculty have noticed a significant change in a student and are concerned. There are a myriad of reasons for a student’s slipping grades, sudden inattentive behavior or circulating rumors, but the counselors don’t know unless they ask.

“Sometimes the parents are great about it, and other times parents are like ‘no, we’re good, we’re fine,’” said Kuesel. “That’s a challenge to us, because we’re like ‘we just want to help.’”

In addition to parental resistance, the adolescent may not want help.

“Resistance is normal, so nobody really wants to see that they have an issue,” said Blanche “And so a lot of times you’ll hear the word denial, but I don’t think denial does it great justice because it’s just that people don’t want to change, innately, people struggle with owning their stuff.”

But even when an adolescent or adult gets help, relapse is a reality. Blanche said his biggest challenge is explaining that just because an addict relapses, that doesn’t mean treatment isn’t working. For an addict that has been actively using for 10 or 15 years, one 30-day program isn’t enough, he said.

“Sometimes they might relapse or they might have a problem. Or sometimes I put it on treatment providers – that we didn’t set up the right level of after care,” said Blanche. “The idea is the more you’re involved in treatment, your recovery is enriched.”

Both Kuesel and Blanche said Chester County is lucky to have so many recovery resources and West Chester specifically has a great recovery community.

“I know addiction is a devastating disease. I know it really affects the family. I know it affects a lot of the community,” said Blanche. “However, I know that when an addict or alcoholic can get clean, they’re unstoppable. They can really do so much with their life.”